The development of atherosclerosis in animal models and the incidence of coronary heart disease in postmenopausal women are markedly reduced by estrogen treatment. Estrogens have acute beneficial effects on vascular reactivity and longer‐term effects on critical steps in the pathogenesis of atherosclerosis. Phytoestrogens present in soybeans and other plant products are weak estrogens but appear to have potent beneficial effects on the arterial wall. The phytoestrogens have certain similarities to ‘designer hormones’ which are being developed to retain their beneficial effects on the cardiovascular system and the skeleton without having cancer promoting effects on the breast and endometrium. Curr Opin Lipidol 9:457–463. © 1998 Lippincott Williams & Wilkins